Acne vulgaris
Also known as: acne vulgaris, comedonal acne, inflammatory acne, papulopustular acne, nodulocystic acne
Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit presenting with comedones, papules, pustules or nodules. TCM differentiation commonly involves Lung Heat, Stomach Heat, damp-heat, phlegm with blood stasis, or constitutional deficiency.
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Lifestyle & Diet
- •Use a gentle non-comedogenic cleanser and avoid repeated scrubbing, squeezing or picking lesions.
- •Select non-comedogenic moisturisers, sunscreens, cosmetics and hair products.
- •Review whey protein, high-glycaemic foods and dairy only where history suggests a reproducible relationship; avoid unnecessary dietary restriction.
- •Change pillowcases, clean phones and wash reusable masks or helmet liners regularly where they contact affected skin.
- •Shower after heavy sweating and remove occlusive clothing promptly.
- •Support regular sleep, stress management and bowel habits without presenting lifestyle measures as substitutes for indicated medical treatment.
- •Advise that acne treatments commonly require consistent use over several weeks and that early review is appropriate if scarring develops.
Cautions & Contraindications
- •Do not needle through pustules, cysts, abscesses, infected follicles, open wounds or compromised skin.[]
- •Do not delay dermatological referral for acne fulminans, acne conglobata, severe nodulocystic disease, progressive scarring or major psychological distress.[,]
- •Avoid strong blood-invigorating herbal strategies during pregnancy and use caution with anticoagulant or antiplatelet medicines.[]
- •Check all herbal prescriptions for interactions with isotretinoin, hormonal therapy, antibiotics and other prescribed acne medicines.[]
- •Do not advise cessation of prescribed topical or systemic medicines without consultation with the prescribing clinician.[,]
- •Avoid aggressive cupping, scraping, dermal needling or heat therapies over actively inflamed acne.[]
- •Use caution with drying or bitter-cold formulas in patients with marked Spleen Qì deficiency, poor appetite, loose stools or constitutional cold.[,]
When to reassess or seek care again
- •Allow 8–12 weeks before judging response to any topical, oral, or acupuncture regimen — acne turnover is slow.[,]
- •Reassess at 6 weeks for tolerance, adherence, and early scarring; adjust pattern differentiation and lifestyle advice.[,]
- •Refer promptly if scarring, nodulocystic lesions, or significant psychological distress emerges.[,]
- •High-glycaemic-index and dairy-heavy diets; excessive spicy, fried, or sweet foods (Damp-Heat).[,]
- •Menstrual-cycle hormonal shifts, PCOS, and premenstrual flares.[,]
- •Occlusive cosmetics, sports helmets/masks, and picking or squeezing lesions.[]
Any sudden severe flare with fever or systemic upset (acne fulminans) requires urgent dermatology referral.
Frequently Asked Questions
What are the main TCM patterns associated with acne vulgaris?+
Common patterns include Lung Heat, Stomach Heat, damp-heat with toxicity, and phlegm combined with Blood stasis. Differentiation depends on lesion type, distribution, chronicity, associated symptoms, tongue and pulse [4].
Which acupuncture points are commonly considered for acne?+
LI11, SP10, ST44, ST40 and DU14 are commonly considered, with additional points selected according to Heat, Dampness, phlegm, Blood stasis, menstrual factors and constitutional findings [4].
When should acne be referred for dermatological assessment?+
Refer severe nodulocystic acne, acne conglobata, acne fulminans, progressive scarring, diagnostic uncertainty, treatment resistance, secondary infection or acne causing significant psychological distress [1].
Can Chinese herbal medicine be combined with prescribed acne treatment?+
Concurrent care may be appropriate after reviewing medicines, liver risk, pregnancy status and potential herb–drug interactions. Prescribed treatment should not be stopped or altered without the prescribing clinician's involvement [4].
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Sources & Further Reading
Clinical guidance, red flags and safety notes on this page draw on the following current sources alongside the classical references above.
- DermNet NZ · 2024
- NICE CKS · 2024
- Therapeutic Guidelines (Australia) — Dermatology · 2024
- People's Medical Publishing House · 2017
Reference for 粉刺 / 肺风粉刺 pattern differentiation.
Educational reference for licensed practitioners. Not a substitute for individual clinical assessment. Refer to conventional care for any red-flag or undiagnosed presentation.